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Do we need full compliance data for population pharmacokinetic analysis?

  • Pharmacometrics
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Abstract

For population pharmacokinetic analysis of multiple oral doses one of the key issues is knowing as precisely as possible the dose inputs in order to fit a model to the input-output (dose-concentration) relationship. Recently developed electronic monitoring devices, placed on pill containers, permit precise records to be obtained over months, of the time/date opening of the container. Such records are reported to be the most reliable measurement of drug taking behavior for ambulatory patients. To investigate strategies for using and summarizing this new abundant information, a Markov chain process model was developed, that simulates compliance data from real data from electronically monitored patients, and data simulations and analyses were conducted. Results indicate that traditional population pharmacokinetic analysis methods that ignore actual dosing information tend to estimate biased clearance and volume and markedly overestimate random interindividual variability. The best dosing information summarization strategies consist of initially estimating population pharmacokinetic parameters, using no covariates and only a limited number of dose records, the latter chosen based on an a priori estimate of the half-life of the drug in the compartment of interest; then resummarizing the dose records using either population or individual posterior Bayes parameter estimates from the first population fit; and finally reestimating the population parameters using the newly summarized dose records. Such summarization strategies yield the same parameter estimates as using full dosing information records while reducing by at least 75% the CPU time needed for a population pharmacokinetic analysis.

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Authors and Affiliations

  1. Department of Pharmacy, School of Pharmacy, University of California, San Francisco, California

    Pascal Girard (INSERM Research Fellows) & Lewis B. Sheiner

  2. Service de Pharmacologie Clinique, Hopital Cardiologique, BP 3041, F69694, Lyon Cedex 03, France

    Pascal Girard (INSERM Research Fellows)

  3. Department of Laboratory Medicine and Medicine, School of Medicine, University of California, Room C255, Box 0626, 94143-0626, San Francisco, California

    Lewis B. Sheiner

  4. Division of Clinical Pharmacology, Stanford University, Palo Alto, California

    Helen Kastrissios & Terrence F. Blaschke

Authors
  1. Pascal Girard
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  2. Lewis B. Sheiner
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  3. Helen Kastrissios
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  4. Terrence F. Blaschke
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Additional information

Work supported in part by Cooperative agreements AI 27663 and AI 27666 from the National Institute of Allergy and Infectious Diseases, U.S. Department of Health and Human Services. Dr. Girard's salary supported in part by Grant No. 1 F05 TW05185-01 from the Fogarty International Center, National Institutes of Health, U.S. Department of Health and Human Services.

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Girard, P., Sheiner, L.B., Kastrissios, H. et al. Do we need full compliance data for population pharmacokinetic analysis?. Journal of Pharmacokinetics and Biopharmaceutics 24, 265–282 (1996). https://doi.org/10.1007/BF02353671

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  • DOI: https://doi.org/10.1007/BF02353671

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